240 CHAPTER 6
study on suicide prevention: Those with any suicidal ideation, only those with
a concrete plan, or those who have already tried once? Moreover, people who
have already made at least one attempt may differ from those whose fi rst attempt
results in death. Another problem is determining what constitutes an appropriate
control group. It would be unethical not to offer suicidal individuals in a control
group the same level of services as those in the treatment group (De Leo, 2002b).
Figure 6.8
6.8 • Feedback Loops in Action: Suicide
Brain Systems
Neural Communication
Mental Processes and
Mental Contents
Gender/Culture
Frontal lobes
Serotonin
Genetics
Inherited
vulnerability
to depressive
disorders
Poor coping skills
and problem-solving
abilities
Distorted and rigid
thinking
Affect Behavior
Hopelessness
Despair
Previous suicide
attempt(s)
Impulsivity Gender and cultural
differences can lead to
alienation
Religion
NeuroPsychoSocial
NeuroPsychoSocial NeuroPsychoSocial
Family
No known major
contribution
Stressful Life Events
Life challenges